Aim. To assess impact of pharmacist managed anticoagulation management service on Egyptian atrial fibrillation patients' anticoagulation management, incidence and severity of bleeding events and thromboembolic events, incidence of warfarin drug and food interactions. Methods. Prospective, randomized, controlled study. Patients presenting to Cardiology Department, Ain Shams University Hospitals, Cairo, from November 2012 to February 2014, were assessed for eligibility. Inclusion criteria; newly diagnosed AF patients who would receive anticoagulation with warfarin, aged 18- 80 years, moderate to high risk of developing stroke. Exclusion criteria; patient with renal disorder or on renal dialysis, pregnancy or lactation, dementia, moderate to severe hepatic disorder, valvular heart disease, clinically significant active bleeding, recurrent DVT or PE. Patients were randomly assigned to; control (routine medical care group); 30 atrial fibrillation patients subjected to regular care, or study (pharmacist group); 30 atrial fibrillation patients subjected to pharmacist managed anticoagulation management service. For both groups; demographics, anticoagulation knowledge assessment questionnaire (AKA) and INR were assessed initially and patients given a side effect self-reporting card. Study group was subjected to a systematic anticoagulation management and education. Follow up was done continuously for 6 months for both groups and final evaluation included; percentage time in therapeutic range (TTR), anticoagulation knowledge assessment questionnaire (AKA), side effect, warfarin drug and food interaction reporting.